20 Best Supplements for Menopause: Gynecologist’s Guide

Social media is buzzing with the "We Do Not Care Club" for women in perimenopause, menopause and postmenopause. But if there is one thing many women do care about, it is finding relief from menopause-related hot flashes and mood swings and maintaining health and comfort as they age.

This is easier for some than others. After all, menopausal changes are a spectrum, meaning some women experience many symptoms, while others experience only a few or none at all. And relentless, daily hot flashes can make it hard to empathize with a friend whose only complaint is trouble sleeping.

Good nutrition and healthy lifestyle choices can make a difference during this time—and so can nutritional supplements. This includes non-hormonal and herbal options that have been clinically studied to address common menopausal complaints and the bone and heart health matters related to hormonal changes.

Top menopause supplements

As an OB-GYN, my patients often ask me for supplement recommendations. While I consider certain core nutrients fundamental, some are particularly useful for perimenopause and menopause:

1. Siberian rhubarb

This botanical has gotten a lot of attention for menopause relief thanks to its impressive benefits. A clinically studied extract of Siberian rhubarb (R. rhaponticum) addresses 11 common menopausal discomforts, including:

• Hot flashes
• Night sweats
• Irritability
• Mood swings
• Sleep disturbances (and the accompanying exhaustion)
• Discomfort in your joints and muscles
• Vaginal dryness and other sexual function matters

This hormone-free supplement has had impressive results in clinical studies that have ranged from 12 weeks to two years. The more than 400 women involved reported up to an 83% reduction in hot flashes, and a 66% decrease in irritability.

2. Fenugreek

If sexual function is a concern, fenugreek may be able to help. Fenugreek seed extract has several benefits for women, depending on the formula standardization. Clinical studies have found fenugreek support for sexual satisfaction, sexual response and healthy sex hormone levels compared with placebo.

Fenugreek contains phytoestrogens and flavonoids, such as protodioscin and trigonelline, that can encourage the body's natural pathways for estrogen production. A clinical trial found women who took 500 mg of a standardized fenugreek extract daily had improved estrogen balance as well as reporting fewer discomforts like hot flashes, night sweats, mood swings and sleep disturbances.

3. Soy

Soy is a popular supplement for menopausal women because soy isoflavones mimic estrogen-like activity in the body and help maintain strong bones and a healthy heart as you age. These are two areas of health that are affected by fluctuating hormone levels during perimenopause and menopause. Soy isoflavones have been studied to promote menopausal comfort, specifically regarding hot flashes. Due to their antioxidant activity, they also support cellular health and may help maintain already-healthy blood pressure.

4. Saffron

Saffron is another botanical that has different health benefits, such as mood support and libido support; in a clinical study, women who took a specific saffron extract for six weeks reported improved sexual function scores. Studies on a different saffron extract showed improved mood compared to placebo.

5. Ginseng

Ginseng is likely already familiar to you. This adaptogenic herb helps promote healthy energy production and encourages your natural ability to manage stress. These benefits can help you deal with common menopausal complaints, like fatigue and mood swings.

Top vitamins for women in menopause

The top vitamins for women are helpful not only for menopause but for health and wellness throughout your adult life:

6. Vitamin D3

Vitamin D is essential for adults of every age, and it famously promotes bone and immune health, as well as heart health, brain function and a healthy inflammatory response. We can get vitamin D from many sources, including exposure to sunlight and different foods, but it is hard to get enough vitamin D from those sources alone. I recommend taking vitamin D3 with vitamin K daily to help maintain vitamin D blood levels in the optimal range. (You can easily monitor your blood levels of D3 with a simple lab test.)

7. Vitamin K

It turns out vitamin K is as important for your bone health as vitamin D. Vitamin K helps maintain your body's calcium balance, which affects everything from cardiovascular health to bone density. Your ideal supplement routine will include both of these vitamins daily, either as standalone supplements or as part of a targeted formula for bone or heart health.

8. Multivitamin

A single formula that contains the RDAs of many vitamins and supplements is a great way to be proactive about your health, especially as you age. A quality multivitamin can help fill the gaps in your daily diet and keep your body at its best.

Top minerals for menopause

Much like vitamins, some minerals are recommended for women's wellness at any age—and menopause is not a good time to let this lapse!

9. Magnesium

As you age, magnesium levels naturally decline. And this mineral works throughout your body in more than 600 biochemical processes affecting your muscles, nerves, bones and heart. Magnesium also helps to transport calcium and potassium to your cells, making it key for bone and cardiovascular health.

10. Calcium

Bone density becomes increasingly important for healthy aging as women approach menopause. Calcium is essential for maintaining strong bones, and it works in concert with vitamins D and K and with minerals like zinc and magnesium to support bone mineralization and bone health.

11. Zinc

Zinc is a powerful mineral. We are familiar with taking zinc to support our immune system. But zinc also has antioxidant properties, and it promotes neurological health, helps maintain eye health, and plays a role in healthy bones. As with other minerals, we do not produce zinc naturally in our bodies, so it is important to get zinc through diet or supplements.

Other key supplements for menopausal women

Because menopause involves so many changes in the body, a number of other supplements make my recommended list:

12. Probiotics

Probiotics are living microorganisms (like bacteria) that support various aspects of health when taken in adequate amounts. Depending on the strain, probiotics help support digestive health, a healthy immune response, mood health, and more. One probiotic strain, ROSELL® A, has particular benefits for women. It helps maintain vaginal health by encouraging a healthy vaginal microbiome and vaginal tissue health.

There are also strains that target heart health, a healthy inflammatory response, and liver health. You'll even find a saffron-probiotic blend that encourages a healthy mental outlook and supports emotional well-being.

13. Melatonin

One of the most common annoyances of menopause is sleep disturbances, whether that means you struggle to fall asleep or your body suddenly wants to be awake at 3 a.m. Melatonin promotes healthy and restful sleep and supports healthy circadian rhythms to help keep your days and nights on an even keel. When starting melatonin supplements, you want to start at the lowest dose and work your way up to find out which dosage is right for you.

14. DHEA

One of the most abundant hormones produced by our adrenal glands, DHEA is a precursor to many of the hormones our bodies make (this applies to men as well as women). DHEA declines as we age, and this may affect our muscle mass and strength, cognitive function, memory, energy and libido. Supplementing with DHEA can support healthy bone and muscle mass as well as brain health and healthy sexual function in women.

Note: Always talk to your healthcare provider before you start a DHEA supplement. It is important to check your DHEA levels beforehand and continue testing while supplementing.

15. Indole-3-carbinol

Hormone health is a challenge during perimenopause and menopause. I3C (indole-3-carbinol, from cruciferous vegetables such as broccoli, Brussels sprouts and cabbage) not only promotes healthy estrogen metabolism, but also encourages liver enzymes that help inhibit estrogen metabolites and xenoestrogens (estrogen-like environmental compounds). This promotes hormone balance and breast health in women.

16. Diindolylmethane (DIM)

Another supplement that supports hormone balance and breast health, (DIM) comes from broccoli. Like I3C, it supports estrogen metabolism and promotes healthy liver enzymes that help metabolize estrogens and xenoestrogens.

17. Collagen

Collagen is the most prominent protein in our body, but we naturally produce less with age. This can affect everything from hair and skin health to muscles, bones and joints. Collagen is a structural protein, and maintaining healthy levels can support healthy skin and hair, help reduce the appearance of wrinkles, and promote joint health and comfort. Studies of hydrolyzed collagen, or collagen peptides, have found daily supplementation promoted knee comfort and encouraged skin elasticity when compared with placebo.

18. Phytoceramides

Speaking of skin and hair health, supplemental ceramides, which support hair health and help smooth the appearance of wrinkles, can also help hydrate and revitalize your skin from within. Ceramides are lipids, or fats, in the outermost layer of your skin's surface that help lock moisture into your skin. They contribute to youthful-looking, smooth skin—and when we produce fewer of them as we age, it's written all over our faces. Supplementing with ceramides promotes healthy skin hydration and comfort and smooths the appearance of fine lines and wrinkles.

19. Omega-3 fatty acids

Omega-3s have a well-earned reputation for supporting heart health. Omega-3 fatty acids support healthy heart and blood vessel function, promote blood flow, and help maintain already-healthy blood pressure and HDL cholesterol levels. But they are good for your brain as well. Omega-3s promote healthy aging and cognitive function, and they help inhibit inflammatory factors to support whole-body health. This makes omega-3s and fish oil a good addition to your supplement routine, especially since many adults do not get the recommended amount from diet alone.

20. Bladder support

Fluctuations in bladder function are common with age and menopausal changes. A proprietary blend of lindera, horsetail and three-leaf caper has been studied to support bladder health and promote healthy urinary frequency for women, even at night. A clinical study found women taking this plant-based formula reported better bladder comfort, as well as better ability to maintain healthy urinary patterns.

“When I discuss menopausal changes with my patients, I try to identify what is bothering them the most. Understanding why the body is feeling this way is a great help to women and can help them adopt a lifestyle and supplement routine that is beneficial for them.”

How to choose the right supplements for menopause

When I discuss menopausal changes with my patients, I try to identify what is bothering them the most. Understanding why the body is feeling this way is a great help to women and can help them adopt a lifestyle and supplement routine that is beneficial for them.

Not sure where to start? This chart is a good guide to get you started:

References

• Dubey VP, et al. "Efficacy evaluation of standardized'Rheum rhaponticum'root extract (ERr 731'®) on symptoms of menopause: A systematic review and meta-analysis study." J Biomed Res. April 2024. https://pubmed.ncbi.nlm.nih.gov/38646867/
• Dudonné S, et al. "Efficacy of a wheat polar lipid complex in reducing hair loss and improving hair growth in healthy women: A'randomized, double-blind, placebo-controlled clinical study." Int J Cosmet Sci. April 2024. https://pubmed.ncbi.nlm.nih.gov/37935579/
• Gatenby C, Simpson P. "Menopause: Physiology, definitions, and symptoms." Best Pract Res Clin Endocrinol Metab. January 2024. https://pubmed.ncbi.nlm.nih.gov/38171939/
• Khanna A, et al. "Efficacy of a novel extract of fenugreek seeds in alleviating vasomotor symptoms and depression in perimenopausal women: A randomized, double-blinded, placebo-controlled study." J Food Biochem. December 2020. https://pubmed.ncbi.nlm.nih.gov/33025616/
• Kröse JL, de Baaij JHF. "Magnesium biology." Nephrol Dial Transplant. November 2024. https://pubmed.ncbi.nlm.nih.gov/38871680/